Newly diagnosed...have many questions

[trowter]

Hi there:
I was dianosed with Type 2 diabetes last week. After going to the dietitian, I have a lot of questions.
Do I have to eat starch with every meal?
The same for fruit. Do I have to eat a piece of fruit with every meal?
I really don't understand why I have to eat fruit and starch with every meal, when that is the very thing that my body can't handle. There must be some significance to eating these with every meal, I just don't know what it is.
This is all very confusing right now, and maybe if I understood it, the fog might begin to lift.

[MarkMunday]

I really don't understand why I have to eat fruit and starch with every meal, when that is the very thing that my body can't handle.
I haven't been able to get a sensible answer to that question. And I stopped taking dieticians seriously a long time ago. I simply do what works best for me. And limiting carbs wherever possible produces the best results, both short-term and long-term.

The dieticians are well-meaning. But they simply regurgitate what they read in books. INMHO, the conventional group-think about nutrition has become seriously warped and out-of-shape over the years.

Cheers,

Mark

[The9thPawn]

trowter, welcome to the forums, its a great place to ask questions and get answers. I'm newly diagnosed myself (about 5 weeks ago) so I'm still learning myself. In reality I think most here are still "learning" about the disease too. Someone more qualified on the subject can answer your question better then I, but I will share something that my dietitian mentioned.

She said to not exclude all fruit carbs and starches from my diet. Many people, in her experience, would cut out nearly ALL fruit carbs and starches realizing that they are "bad". But doing so would cause more difficulty then benifits from doing so. So she urged me to make sure I include them both somewhere in my diet, but in moderation.

Now in my case personally, my doctor didn't even recommend to get this drastic (he wasn't even going to recommend the dietitian until I urged him to do so). His main advice to me was to lose some of the excess weight first, before I try to change anything else. Losing even 30 lbs will make it so much easier to control my sugar levels. So I honestly do not care (yet) about how much fruit I have. Fruit carbs are natural, and I just try to cut out most of the processed types carbs (pastries, pasta, sugar filled sodas, etc). Thats just for me though, and mainly because I was diagnosed without any major symptoms yet. So it may be that its not as serious for me as it may be for you or others.

Hope this helps, and again welcome to the site eh.

[Harold]

Do I have to eat starch with every meal?
The same for fruit. Do I have to eat a piece of fruit with every meal? There must be some significance to eating these with every meal, I just don't know what it is. Not sure what you mean exactly by starch. You could be talking vegetable and / or grains, and dieticians would like us to have both with each meal as well as the fruit. The idea behind this is to get a well rounded nutritous diet. Which when eating small meals becomes difficult to include all three and protien. The thought behind small meals is to dampen large swings in blood glucose levels. Never been much of a fruit eater myself and find it hard to have even one fruit everyday. Having a vegetable every meal (breakfast) also is a pain. So what I do is to try to take it as a daily total and have a fruit as a snack and have vegetables twice a day. Starches from grains and potatoes I go lite on and eat very little of them and not every day. Eating at least one and preferably two well rounded meals everyday makes sense, but for many not very practible. You will need to experiment with your diet to learn how it affects you and you will find as time goes by you need to do it again. We are all constanly learning about this desease and most of all about ourselves.

[mg_2204]

Hello Trowter and welcome! :)

A dietician may be helpful at times (especially if you want to find new ways to cut down on fat, etc), but I find that I do better on my own, when I experiment with my meter.

I too was told to eat plenty of potatoes, bread, etc. There was a time when my body could cope with it fine (during the day that is, my fasting sugars were always the problem).

Bread, rice, pasta, potatoes, they all make my sugars go bonkers if I'm not active enough. I avoid those at supper time or have very little of it. But perhaps because I'm from the old school, I'm not ready to rule out those completely from my diet. I simply have them earlier in the day, when I'm most active. After all, potatoes are a vegetable! Not junk food. And pasta with pesto? Sorry, I can't do without.

I found out it's not just what I eat... it's when and how much too. I would recommend you keep a dietary journal for a few weeks. And make sure you check your blood sugar too. You will soon see what works for you.

The very best to you!

[Peter Lee]

Hi there:
I was dianosed with Type 2 diabetes last week. Do I have to eat starch with every meal?
The same for fruit. Do I have to eat a piece of fruit with every meal?
I really don't understand why I have to eat fruit and starch with every meal, when that is the very thing that my body can't handle. There must be some significance to eating these with every meal, I just don't know what it is.
This is all very confusing right now, and maybe if I understood it, the fog might begin to lift.
I had the same problem when I was first diagnosed but it really is very simple once you find someone who can explain it - it took me a while but I managed to piece together what my diabetes nurse and what my consultant physician were telling me to make a coherent picture. The nurse talks from a diet point of view and the physician from a biochemistry point of view.

The first thing to understand is that Type 2 diabetes is different to Type 1 and what applies to Type 1 people in terms of low carb intake etc does not work for us Type 2 people.

The other thing I have noticed since I joined this forum is that the philosophy of managing Type 2 diabetes in the USA seems to be different to that in the UK and (I think) Canada. I am in the UK.

The philosophy in the UK is that management is achieved through the use of a balanced 'healthy' diet. "There is no such thing as a diabetic diet, only a healthy diet" was what was quoted at me.

Now to the point. You are being told to eat fruit because fruit contains fibre, vitamins and other important nuitritional things. You are being told to eat starch (exactly as I was) because what Type 2s need is to eat complex carbohydrates which effect a slow release of glucose into the blood. Eating fruit plus starch together produces a highly complex mix which, once your medication has become stabilised, means that your body can cope with the release of fructose and carbohydrate into your system.

Why complex carbohydrates and slow release of glucose? Well, if your body thinks that it is not getting any glucose at all what happens is that your liver starts pumping out glucose and your blood sugar goes up. So, if you eat insufficient carbohydrate, your blood sugar can go up. Strange isn't it.

If your medication does not include insulin (which it does for some Type 2s) then your body can't cope with the extra glucose from your liver and the blood sugar stays up.

In my early days after diagnosis when my Metformin hadn't fully kicked in, I could actuall measure this effect - eat a little, sugar goes up - eat more, sugar goes down.

The battle is to take in enough food to live without ingesting too much sugar but to take in enough of the right food to stop the liver pumping out glucose.

If you try and beat the whole thing by living on a fasting diet and hoping that your liver is the source of all your blood sugar, then what happens is that your fat gets metobolised into triglycerides through a complex mechanism and these triglycerides fur up your ateries, helped by the sugar sticking to them. This is one of the reasons we are told to lose weight, particularly from the abdomen.

It's a fun world the world of diabetes.

I have a caveat. We are all different and what applies to one person doesn't necessarily apply to another. I repeat that what we are told in the UK seems to be different to what I see on this forum from the USA. What I have written above is my own understanding of what I gleaned from two different medical advisors. You have to sort out for yourself with your own medical people what is right for you.

What I can tell you is that after six months my medication finally stabilised and my sugars stay low using the type of diet that you describe that you have been told to use.

Good luck

[Harold]

The other thing I have noticed since I joined this forum is that the philosophy of managing Type 2 diabetes in the USA seems to be different to that in the UK and (I think) Canada. I am in the UK.

The philosophy in the UK is that management is achieved through the use of a balanced 'healthy' diet. "There is no such thing as a diabetic diet, only a healthy diet" was what was quoted at me. The idea behind this is to get a well rounded nutritous diet. Sorry Peter, I must not be posting enough. Yes, the well rounded balanced diet concept at every meal is taught as a large part of managing this desease in each country, however the exact definition of the same diet does vary somewhat in each country. In the states it even varies depending on who is teaching in the same city.

[SVanderkolff]

Trowter
Welcome from Ontario as well. Another fairly new player in this game, I was diagnosed in January.
There seems to be a fair bit of difference between what the docs tell us and what the dieticians tell us. As was said before in most cases you have to find what works for you. The one thing they all agree on is the weight loss. I can tell yuou from personal experience after losing 20 lbs it is much easier to controll the BG.
Here what I have learned so far:
lose weight
drink water
test often
figure out what works for you

Hope that helps
Steve T2

[duck]

I have never understood how healthcare professionals could advise a Type 2 diabetic not to test often...I guess my confusion comes from my whole "how do you know where to go if you don't know where you are" mentality to treating diabetes...

Mr Vanderkolff hits on an important topic when it comes to what your DOCTOR will tell you versus what your DIETITIAN will tell you: MD's only have to have about four hours of training in nutrition during the med school studies, at which time diabetes is touched on...Dietitians on the other hand spend upwards of four years studying various maladies and the effects on nutrition therein--Hedging my bets, I am inclined to listen to the Registered Dietitian in regards to diet.

[liz32]

hi and welcome :p from the maritimes! If you don't eat any startches your liver will produce the sugar anyways and often at a higher level. I just found this out from my diabetic nurse because when my B/s were high, I'd cut out the carb and then end up with even higher sugars. I'm not saying I understand why, but that's the info I got. Hope this helps.

[trowter]

Wow...What a friendly site!!
Thanks for all the information. I really appreciate the help. I should have told you more about myself.
I was just diagnosed last week. My fasting was 7.2, (130) my a1c was 6.1, and the GTT was 13.7 (247) at 1 hr and he didn't say what it was at 2 hr.
The other tests he did were cholesterol which was mostly fine too. The only one that came up a little high was the triglycerides (whatever that is).
My doctor has not prescribed any medication...just the dietician. I am overweight, so I think he is hoping that getting my weight down will help control it.
I did find it funny that my doctor didn't send me to the diabetic educator...and he didn't tell me to test my blood either.
Again, thanks for all the information...I think I'll be spending a lot of time on this site going forward

[TvBabe]

Wow...What a friendly site!!
Thanks for all the information. I really appreciate the help. I should have told you more about myself.
I was just diagnosed last week. My fasting was 7.2, (130) my a1c was 6.1, and the GTT was 13.7 (247) at 1 hr and he didn't say what it was at 2 hr.
The other tests he did were cholesterol which was mostly fine too. The only one that came up a little high was the triglycerides (whatever that is).
My doctor has not prescribed any medication...just the dietician. I am overweight, so I think he is hoping that getting my weight down will help control it.
I did find it funny that my doctor didn't send me to the diabetic educator...and he didn't tell me to test my blood either.
Again, thanks for all the information...I think I'll be spending a lot of time on this site going forward


Trowter I'm also in BC, I am very surprised your doctor didn't refer you to a Diabetes Clinic. They have so much to offer you! Next time you see your GP insist on a referral to an educator. I live in Port Coquitlam and I go to the Diabetes Clinic at Eagle Ridge Hospital and it has been extremely helpful to me! As well as having access to an educator and dietician they also have excellent free classes you can sign up for on various topics e.g. How to grocery shop for your diabetes, Heart Friendly program, How to monitor and exercise, Carb Counting, these are just a few examples and you are entitled to these programs. So stick up for your rights and tell that GP of yours to start providing you with the resources you need to keep your diabetes in control :)

[Cinnabon]

Hey there,
I have to admit that living with Diabetes is very confusing till you get a grip on handling it. The food factor is best by trail and error. It is different for every diabetic, I had a friend that ground beef would higher her Blood sugar levels more than cake. Its a testing phase right now, before you know it you will know exactly what affects you best.

[Peter Lee]

Hey there,
I have to admit that living with Diabetes is very confusing till you get a grip on handling it.
I think you have hit on a very important point here.

My experience says that the person who knows best about what is good for the patient is the patient themself - once they have some basic understanding of their condition.

I liken it to running a company. I am the chairman of my board. My GP, diabetes consultant physician and diabetes nurse form my board. I listen to what they tell me, ask questions, make sure that the answers make sense, ask follow-up questions if necessary and then reach an agreement on what should be done that is best for me.

Sounds easy, but the problem is that doctors don't like being asked questions that require a considered answer and put in terms that a layman can understand! I think that this is why people don't have enough information to understand what is happening to them and is why this forum is so important. What we do here is to share information, share experiences and offer each other support so that we can manage our condition better. A big problem is for us as patients to have the confidence to take control and just use the medical team as informed advisors rather than as gods.

Phew! I'm glad I got that off my chest but it did take me many months to understand what is happening to me and without this forum's support I doubt I would have had the strength to get through the first month after diagnosis.

[Peter Lee]

Sorry Peter, I must not be posting enough. Yes, the well rounded balanced diet concept at every meal is taught as a large part of managing this desease in each country, however the exact definition of the same diet does vary somewhat in each country. In the states it even varies depending on who is teaching in the same city.
I was really talking in very general terms (but I had genuinely formed that impression) and what you say about the variation in ideas about what constitutes a good diet makes sense - different cultures, different ideas.

[Lynne]

I'm still waiting to be seen at the Diabetes Clinic, after attending a 1-hour meeting in Dec. 2004. They have such a huge waiting list that I'd be out of control before my individual assessment if I had not taken control of diet by myself. I've been told I'll be called for an August 2005 appointment.

I seldom touch fruit, but I do take Omega 3/6/9 fish oil, a multivitamin and folic acid to compensate. I eat under 50 grams of carbs a day, that's what works for me.

[Donegalmike]

Welcome from Northern New Hampshire, hey I am almost into Canada ;) I am also new to type 2 diabetes. It's been 3 weeks now and I've been to the dietician and what I learned from her was that yes, we need to cut down on carbs but not to cut them out completely. You still need carbs for energy and what I do is read the packaging and go by the serving suggestion. I try to stay under 24g of carbs per meal. I have found following the serving sizes helps me alot. If you do want to eat something high in carbs cut the serving in half. For me it's reading the package and being aware of the number of carbs I take in. :thumbsup:

[trowter]

Thanks for the wonderful welcome. It's unfortunate to meet you people under these circumstances, but I guess there will be a silver lining in this cloud.
I notice some of you have cut down on your carbs as a way of controlling your type 2. I am trying that avenue right now, and seem to be feeling better.
I followed my dietician's diet for 5 days, until I couldn't take it anymore. My migraine just kept getting worse and worse. She was suggesting 45 - 60 grams of carbs with every meal which isn't very high considering what I was eating before I was diagnosed. I don't know what was causing the migraine, but changing to low carb and more protein, got rid of the headache by the next morning.

[HeatherP]

Just keep an eye on your cholesterol and triglycerides to make sure they're not going up.

(in my book anything that prevents a headache is a good thing! ;) )

[liz32]

Hi lynne from another bluenoser. I don't know where you're at in the province but there must be another way around waiting for a clinic. I was diagnosed in January and was in clinic in march..no where near the length of time you're mentioning. You could call the diabetes society in Halifax and they will send you an info packet until you get in. From what you've said, you are eating way too few carbs. I was advised to have around 200 grams per day in a well rounded diet. If you don't eat enough, your liver will put out sugar to compensate. I honestly think you need to call your doc again or someone. I went to the Cobequid Center in Lower Sackville. Here's the number for where they do appointments..902-473-3722. I don't know if they'll do anything faster but it's worth a try..or they could at least give you info. Anyways, sorry to go on but your wait time is way too long. I couldn't imagine having to wait that long to get some help. Let me know if there's anything else I can find out for you. Take care :p